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San Francisco launches new conservatorship measures to help patients with mental illness

San Francisco Mayor Mark Farrell recently announced the addition of more conservatorship beds to help individuals who suffer from serious mental illnesses. He said with more than double the number of beds, there will be “real results” for ill patients.

The San Francisco Healing Center at St. Mary’s Medical Center received 54 new locked psychiatric beds. The beds are an effort to help people who are placed in conservatorship because they are unable to live independently due to their illnesses, but do not need constant hospital care. They provide an alternative to placing patients in out-of-county facilities, hospitals or jails.

State senators are also working on legislation to expand and strengthen California’s conservatorship laws. Conservatorships are currently limited to elderly individuals vulnerable to abuse as well as people with severe disabilities or cognitive limitations. The bill seeks to give counties more options to address homeless individuals who are trapped in a cycle of going in and out of jails, hospitals and other government services.

San Francisco Board of Supervisors President London Breed also introduced a measure that decriminalizes mental health conservatorship. It puts the city attorney in charge of overseeing such cases instead of the district attorney.

Conservatorships may be needed in circumstances where a person is unable to make one’s own financial and health care decisions due to physical or mental incapacity. In California, a civil court judge establishes a conservatorship by appointing someone to make decisions on behalf of the incapacitated individual. While a conservatorship may be necessary in some cases, it can typically be avoided if the person has previously signed an Advance Health Care Directive or Durable Power of Attorney.

California may allow on-campus medical marijuana use for special needs students

Some children who have special needs depend on marijuana for medical treatment due to its purported therapeutic properties. Now, a California senator has introduced a bill that would allow local school boards to create policies that permit on-campus medical marijuana use for special needs students or those with serious disabilities.

Sen. Jerry Hill, D-San Mateo, who introduced the bill, said in a statement that the goal is to give “students access to the medicine they need so they have a better chance for success in the classroom and in the community.”

Under the measure, the child’s parent or guardian would be able to administer medical marijuana in various forms such as capsules, topical creams, tinctures or oils on school campuses that have the approval of the school district’s governing board. Currently, students from kindergarten through grade 12 must be off campus in order to have medical marijuana administered to them.

The legislation gives charter schools, county boards of education or governing boards of school districts the option to pass more permissive policies. Students seeking to use medical marijuana on campus would need to have a doctor’s recommendation.

As there are many different laws governing medical marijuana use, lawmakers are seeking to address any statutes that could potentially conflict with the measure. It appears the key force behind the legislation is ensuring the safety of special needs students. “We want to make sure that these children are able to take this medicinally recommended product in a safe environment rather than out on the street,” Hill said.

California faces growing concerns and lawsuits over nursing home evictions

California has been at the center of a renewed focus on patient dumping and unlawful nursing home evictions. Local and federal regulators are looking to enhance the enforcement of laws that protect nursing home residents.

A lawsuit was recently filed in Santa Clara County Superior Court against SavaSeniorCare, a national nursing home chain. Six of its California facilities were accused of illegally evicting nursing home residents. They allegedly refused to provide patients with advance written notices of discharge or inform them of their right to appeal the discharge.

The lawsuit claimed SavaSeniorCare favored profit over following longstanding rules designed to protect residents. Last year, the AARP Foundation filed a similar lawsuit against a Sacramento provider.

Nursing homes have a legal duty to provide 30 days’ notice before discharging a patient involuntarily. They must also notify the appropriate parties, give a specific reason for the eviction and offer the resident a chance to contest the decision. In addition, the nursing home is required to help arrange the individual’s transfer to their home or another long-term care facility.

Evictions have to meet a limited set of criteria in order to be justified. For example, a patient may be discharged because of their failure to pay, the facility’s closure or inability to meet the resident’s needs, or because the resident poses a risk to others’ safety. Many nursing homes misinterpret the reasons and engage in patient dumping for monetary gains.

Legislation that aims to deter the practice of patient dumping has been introduced in the California State Senate. The measure would ensure nursing homes discharge patients to their specified place of residence or to another licensed facility.

Unfortunately, far too many residents nationwide are unaware of their rights and are evicted without an appeal. As a result, they end up without permanent housing or the routine medical care they need upon discharge.

How robots could help ease the looming caregiving shortage

The United Nations estimates that the global population of elderly individuals will increase 56 percent by 2030. However, the number of professional caregivers is expected to fall short.

Researchers at Oklahoma State University believe that robots could be the key to meeting the growing demand for caregivers. Engineering professor Weihua Sheng and his team are developing robots that are able to provide companionship to elderly individuals and detect potential problems.

The first model is an interactive tabletop robot designed along the lines of home assistants like Alexa or Google. The robot’s capabilities include asking questions, logging vital statistics and having the ability to detect falls. After finding out where the fall occurred, the robot can then contact the person’s doctor. The second prototype is a mobile robot that is equipped to move through a single-story house.

Sheng said his project aims to improve the lives of elderly people and enable them to be more independent. “Because of the shortage of nurses and doctors and home health care providers . . . many older adults are not able to access those kinds of caregiver resources,” he said. “That’s why we need technology to help them.”

One of the main issues with robot caregiving is a lack of empathy and emotional connection with patients. Sheng and his team are planning to address that by conducting trials at a retirement community.

“We’re trying to improve the intelligence of the robots so they can recognize emotions and facial expressions, which can provide a context for the human-robot conversation,” said Sheng. He predicts similar robots will be available for sale in the next decade or so at a price point ranging from $1,000 to $2,000. Although robots are unlikely to take over the entirety of caregiving, they may help lighten the load on caregivers in the future.

Hugh Hefner’s will forbids heirs from using drugs and alcohol

Hugh Hefner was vocal about his dislike of drugs and alcohol, as well as his concerns about substance abuse. It appears that the Playboy founder, who died in September 2017 at age 91, drafted his will to reflect those views.

Hefner’s trust includes a clause that blocks his heirs from accessing their inheritance if they are found to have engaged in substance abuse. It says that if any of his four children or his widow become “physically or psychologically” dependent on drugs or alcohol, they will not be able to obtain any money. The rule also applies to clinical dependence on alcohol consumption or use of chemical substances that are not prescribed by a psychiatrist or doctor.

According to the will, the inheritance’s trustees will be responsible for determining whether the heirs have violated Hefner’s terms. The trustees can ask them to submit to drug testing at any time if substance abuse is suspected. Payments may restart once the individual in question has remained sober for 12 months or is “able to care for himself or herself again.”

Placing restrictions on an inheritance is not uncommon. Individuals may choose to include drug and alcohol testing requirements out of concern for a beneficiary’s wellbeing, especially if they have an addiction problem. Such clauses are usually intended to protect beneficiaries and ensure the inheritance is distributed according to one’s wishes.

Robot caregivers elicit mix of worry and enthusiasm among Americans

A Pew Research Center survey conducted last year offers some interesting insights into how people feel about robot caregivers and automation in general. Some Americans view robots as a possible solution to the anticipated shortage in caregivers for the nation’s aging population. However, many are concerned about the negative consequences of replacing human caregivers with technology.

One of the earliest caregiving robots ever created was PARO, a therapy robot in the form of a cuddly baby seal that helps patients who suffer from memory loss. Currently, researchers in Oklahoma State University and other institutions are developing robots that can not only serve as companions, but also perform household tasks, assess vital signs, lift people, seek assistance in emergencies and dispense medication.

Around 40 percent of survey respondents expressed interest in the idea of having a robot caregiver. They believe that such technology would help young people worry less about caring for elderly family members. In addition, robot caregivers would allow older adults more independence and enable them to remain in their own homes longer.

Among those interested in using robot caregivers, just over 20 percent feel they would provide better, more reliable care than paid human caregivers today. For example, a robot would not get tired nor let emotions or biases affect the quality of care provided. In addition, they can help ease the burden on family members who are often juggling other responsibilities.

Conversely, nearly 60 percent of adults said they would not want robot caregivers for themselves or loved ones. The main reason for this appeared to be a lack of trust and compassion. While some people believe that the human touch can never be replicated by technology, others are worried about robots making mistakes in caring for their family members. Some survey respondents liked the idea of having a human remotely monitor the robot, such as via video surveillance.

Attorney Michael Gilfix featured as Great Giver in PACE newsletter

Attorney Michael Gilfix was recently recognized for his generous support of the nonprofit Pacific Autism Center for Education (PACE). He was featured as a “Great Giver” in the Spring 2018 issue of the PACE Setter newsletter in acknowledgement of his positive impact on the community.

Gilfix is a nationally known authority in the fields of elder law, estate planning and special needs trusts. He is a founding partner of Gilfix & La Poll Associates. The Palo Alto-based law firm has been a pioneering force in its commitment to advocating for elders, individuals with special needs and others who lack representation.

Gilfix & La Poll and PACE have once again partnered for the annual Special Needs Trust seminar to provide helpful information to families of children with special needs. This year’s seminar was held on May 2 in Palo Alto.

Read the PACE feature article here

ER visits increase disability risk for seniors, says study

An elderly individual’s emergency room visit for an injury or illness could signal serious health problems, according to recent research. Adults aged 65 and older who make a trip to the ER are at a 14 percent higher risk of experiencing disability and physical decline up to six months after discharge than seniors who do not visit the ER.

The study said that seniors who were admitted to the ER were unable to independently carry out everyday tasks such as bathing, dressing, managing finances or shopping within six months of returning home. Seniors who were already having difficulty with daily activities prior to their ER visit are especially vulnerable during this period.

Experts believe there are several reasons that a trip to the ER can result in negative consequences for the elderly. Individuals who previously had no difficulty in coping with their health may suddenly feel they can no longer handle their injuries or the worsening of a chronic ailment like diabetes. For example, elderly individuals who fall and hurt themselves may limit their movement due to the fear of falling again. They may also require more in-home help.

Dr. Thomas Gill, study coauthor and Yale University professor of medicine, said trips to the ER can result in “a fairly vulnerable period of time for older persons.” He suggested considering “new initiatives to address patients’ care needs and challenges after such visits.”

Researchers said family members and caregivers should pay extra attention to the elderly individual in the first few days after their ER visit. They suggested checking in frequently on loved ones, following through with medical professionals and educating oneself about the tests and treatments that were administered in the ER. Taking such steps can help minimize the health challenges an elderly loved one may face in the future.

Key differences between nursing homes and assisted living facilities

Choosing the right type of senior care for yourself or an aging loved one can be a difficult task due to the many options available. Among the best-known types of residential senior care are assisted living centers and nursing homes. Understanding the basic differences between them and whether they fulfill one’s requirements can help the decision-making process.

An assisted living facility allows one to live rather independently and offers special housing and day-to-day support services for its residents. Onsite staff members provide assistance with bathing, grooming, housekeeping and other daily living. Residents are given meals and have the option to participate in scheduled activities. Very basic health care, such as medication management, may also be offered.

A nursing home is also known as a skilled nursing facility. Seniors in nursing homes receive assistance with day-to-day activities. They are also monitored and cared for by around-the-clock nursing staff. Nursing home residents often have disabilities or chronic medical conditions that require full-time medical care.

Family members dealing with minor age-related issues and who wish to maintain their independence might find that an assisted living community is a good fit. However, elderly individuals who require daily medical support may prefer a nursing home.

Of course, there are many other issues to think about when choosing a living situation for an elderly loved one. Besides varying levels of medical services offered to residents, there are also differences in how seniors and families can pay for their care and the cost of living in such facilities. To learn more about long-term care planning, contact the knowledgeable attorneys at Gilfix & La Poll Associates.

Practical tips for choosing an assisted living facility or nursing home

Last August, the largest assisted living complex in California was sued for poor care of its senior residents. The lawsuit alleged poor worker training, elderly abuse and mistreatment. Residents of the facility claimed they were left unattended, with little access to clean clothing and nutritious food.

Unsurprisingly, such findings raise concerns about how loved ones will be cared for at an assisted living facility or nursing home. Knowing what to look for and being able to identify potential red flags can help families make an informed decision about which facility best meets their needs.

Visiting facilities at different times of the day, such as during meal times or activities, can help one get a better idea of how they function. Check to see whether all areas are clean, safe and comfortable.

The National Center for Assisted Living recommends speaking with administrators, staff and residents. You can learn a lot about a facility by the people who live and work there. Do the residents seem happy?

Observe how staff interact with current residents and whether they appear genuinely friendly and caring. To feel confident that you or your loved one will be well taken care of, make sure to ask questions about staffing levels. Factors to consider are the daytime and nighttime ratios of staff members to residents, as well as how emergencies are handled.

There are countless other considerations. Bringing a checklist during an assisted living facility or nursing home visit can help ensure all your questions are addressed. Additionally, make sure to check whether the facility is in compliance with local and state licensing requirements. Have any complaints been filed against it? It is possible to check a state-licensed assisted living home’s performance record on the Department of Social Services website.